1982, 03-08 Permit: 82A-1560 WoodstovePLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
LOT
BL
SUBDIVISION
OWNER
3. f it ke- 1.430C,F
ADDRESS
E 1'3c
PHONE
LEGAL DESCRIPTION - SEE ATTACHED
rARCEL I(JUMBER/5
4.
CONTRACTOR
ADDRESS
DESIGNER
5. ADDRESS
CHANGE OF USE FROM
6.
TYPE
7, OF
WORK
PHONE
ZIP
PHONE
ZIP
TO
NEW 0 ALT. 0 AD'N. 0 RPL. 0 MVE.
0 BLD. ❑ PLMB. IJ/MECH. 0 M.H. 0 POOL
0 OTHER
Actual Set Backs in Feet
North
South East
Size of Parcel
Type Const.
Occupancy
Valuation
Main Floor
No. Baths
No. Stories
CERTIFICATE
of EXEMPTION
West
Zone Classification
Sprinklered
Oyes ❑No ❑ Req'd.
Building Area in Sq. Ft.
Garage Area
No. Rooms
Req'd.
DESCRIBE WORK
8.cacivAhx: ,
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
Enum. Dist. I Location (Area)
Ownership
Public 0 Private ❑
USE CODE
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this
type of work will be complied with whether specified herein or not. The granting of a permit does not presume
to give authority to violate or cancel the provisions of any other state or local law regulating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATIO
2 ---
SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
B mg Technician
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Storage
FEES COLLECTED
Single $
Building
Plumbing
Mech. :2e. C'7D
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
PERMIT NUMBER
04*
*20.00
*20,00
155,9
03-08-82
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
031-08-82•
156.02
DATE ISSUED PERMIT NO. TOTAL
*2 Q0 0._J